Preoperative Biopsy Pathology Research Articles

Treatment of primary retroperitoneal tumors: Single center experience

Introduction: The aim of our study is to evaluate the results of patients who underwent surgery due to primary retroperitoneal tumors in order to contribute to the knowledge pool in the literature.
 Material Method: The data of patients who underwent surgery due to retroperitoneal tumor at Health Sciences University, Adana City Training and Research Hospital between January 2015 and January 2023 were retrospectively scanned. Approximately 54 patients with a clinical diagnosis of PRT were included in the study. Preoperative demographic characteristics of the patients, such as age at diagnosis, gender, number of surgeries for PRT, preoperative biopsy pathology and symptom status, if any, were recorded. All patients underwent computed tomography (CT) imaging with intravenous contrast. The location, size, density and presence of contrast enhancement of PRT in preoperative imaging methods were recorded. Peroperative incision type and duration, need for erythrocyte suspension transfusion, need for organ resection, complications and length of stay in the postoperative period were evaluated.
 Results: The average age of a total of 54 patients who underwent surgery due to a retroperitoneal mass was 53.8±10.0 years. While 15 (27.8%) of 54 patients with a retroperitoneal mass were diagnosed incidentally, 39 (72.2%) patients were diagnosed symptomatically. The final pathological outcome of all relapsed patients was liposarcoma. The average operation time was 178.7±85.4 minutes. In 12 (22.2%) patients, adjacent organ resection was performed in addition to the mass. The average length of stay of the patients was 6.2±3.1 days. In the postoperative period, one patient required re-operation due to ileus and one patient due to bleeding. Adjuvant therapy was given to 6 (11.1%) patients after surgery. In the final pathology results of the patients, positive surgical margins were detected in 8 (14.3%) patients. Additionally, all of these patients had organ resection. In the Kaplan-Meier survival analysis, it was found that surgical margin had a statistically significant effect on average survival (p

Pathological features of early gastric cancer and its background mucosa after eradication of Helicobacter pylori and their implications for biopsy diagnosis

Objective: To investigate the clinicopathological changes of early gastric cancer, especially its background mucosa, after the eradication of Helicobacter pylori (H. pylori), and to investigate the causes of underdiagnosis in preoperative biopsy pathology. Methods: Ninety cases of early gastric cancer after H. pylori eradication and 120 cases of endoscopic submucosal dissection (ESD) specimens without H. pylori eradication and their corresponding biopsy specimens were collected from Beijing Friendship Hospital Affiliated to Capital Medical University during 2016-2021. The clinicopathological data of the patients were analyzed, and the histopathological characteristics and immunophenotypic results compared. Results: Compared with the early gastric cancer without H. pylori eradication history, the histopathological type of early gastric cancer after H. pylori eradication was differentiated adenocarcinoma, with staggered distribution of cancerous and non-cancerous epithelium in the tumor area. The morphologic characteristics of gastric mucosa in the background of early gastric cancer after H. pylori eradication, were distinctive, including widening of the opening of enterosylated glandular ducts, serrated change of luminal margin, eosinophilic and microvesicular cytoplasm of enterosylated epithelium. Low-grade atypia existed in gastric cancer epithelial cells after sterilization, which might lead to underdiagnosis or missed diagnosis in biopsy pathology. Conclusions: Early gastric cancer and its background mucosa after H. pylori eradication have unique morphological characteristics, which can be used as a clue for pathological diagnosis, improve the accuracy of biopsy pathology and reduce the underdiagnosis.

Survival outcomes of surgery in patients with pulmonary large-cell neuroendocrine carcinoma: a retrospective single-institution analysis and literature review

BackgroundPulmonary large-cell neuroendocrine carcinoma (pLCNEC) is a very rare malignancy originating from the lung and bronchus, and its biological behaviour, clinical diagnosis, treatment and prognosis are poorly understood. Thus, the clinical characteristics and surgical treatment-related prognostic factors of this rare disorder must be explored.ResultsThe clinical data of 59 patients (48 males and 11 females) who were treated by surgery and diagnosed with pLCNEC by postoperative pathology at Peking Union Medical College Hospital from April 2004 to April 2019 were analysed retrospectively. The median patient age was 62 years (38–79 years), and the median duration of disease was 2 months (0.5–18 months). Compared with other lung malignancies, pLCNEC lacks specific clinical symptoms and imaging features, and preoperative biopsy pathology is often insufficient to confirm the diagnosis. The corresponding numbers of patients who were classified into stages I, II, III and IV according to the postoperative pathological tumour-nodal-metastasis stage were 25, 12, 15 and 7, respectively. The median overall survival was 36 months (0.9–61.1 months). The 1-year, 3-year and 5-year survival rates were 76.3%, 49% and 44.7%, respectively. The tumour stage exerted a significant effect on survival (Cox multivariate analysis p < 0.05).ConclusionsFor patients with resectable pLCNEC, multidisciplinary therapy based on surgery may have good survival benefits, and tumour stage is an independent risk factor for the prognosis of pLCNEC.

Obtaining fresh prostate cancer tissue for research: A novel biopsy needle and sampling technique for radical prostatectomy specimens

Fresh or fresh-frozen tissue samples are preferred for molecular profiling as formalin fixation degrades intracellular nucleic acids. Radical prostatectomy (RP) specimens are a valuable source of prostate cancer tissue, but the reliance on whole-organ pathological processing for prognostication limits sampling opportunities. Few studies have addressed specific harvesting techniques using prostatectomy specimens. Ex vivo biopsies were performed on 23 consecutive fresh RP specimens using a purpose-designed needle. A standard sextant approach was used with an additional lateral biopsy on each side. Cores from each lobe were snap-frozen together and sections assessed by a pathologist blinded to the RP and pre-operative biopsy pathology. Comparison with pre-operative biopsies was performed using the t-test and chi(2) statistical tests. Eleven randomly selected RP specimens were further evaluated for the effects of needle tracks and margin perforation. Cancer was detected in 19 of 23 specimens, giving a sensitivity of 83.6%. The average tumor involvement was 28.3% per section compared with 15.6% for pre-operative biopsies (P < 0.02). There was no statistically significant difference between the groups for either Gleason sum score concordance or tumor location concordance. In 3 of 11 cases, needle margin perforation was identified; in none of the cases did it compromise pathological assessment, although in one case a deeper block resection was required. Ex vivo biopsy is a useful technique for retrieving fresh tissue whilst preserving organ morphology in RP specimens. The purpose-designed needle and harvesting technique provide good yields of cancer tissue from a high proportion of sampled prostatectomy specimens.